scholarly journals The validity of proxy-based data on loneliness in suicide research: a case-control psychological autopsy study in rural China

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Lu Niu ◽  
Cunxian Jia ◽  
Zhenyu Ma ◽  
Guojun Wang ◽  
Zhenjun Yu ◽  
...  
Keyword(s):  
Rural China ◽  
Case Control ◽  
Psychological Autopsy ◽  
Autopsy Study

scholarly journals The pattern of life events preceding suicide among the elderly in rural China: a national case-control psychological autopsy study

2019 ◽  
Author(s):  
Qiqing Mo ◽  
Guojun Wang ◽  
Cunxian Jia ◽  
Lu Niu ◽  
Liang Zhou ◽  
...  
Keyword(s):  
Life Events ◽  
Terminal Illness ◽  
Rural China ◽  
The Elderly ◽  
Case Control ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Event Scale ◽  
Life Event

Abstract Background Life events associated with an increased risk of suicide and prior to the suicide in China different from those in Western countries. But there is a lack of summary of the elderly life event patterns on Chinese suicide. The aim of this study was to identify the pattern of life events which precede suicide among the elderly in a Chinese culture context.Methods A two-stage stratified cluster sampling method was used in order to select research sites and 12 counties were randomly selected to recruit cases within three provinces. A case-control psychological autopsy study was then adopted. The study population consisted of 242 suicide cases each with an age of 60 and above, and 242 age-, sex-, and location-matched community living controls. During face-to-face interviews, the information from subjects and proxy informants was obtained by standardized trained investigators. Life events were measured using a 46-item Life Event Scale for the Elderly (LESE).Results About 99.6% of suicides and 88.4% of controls resulted from the experience of at least one life event. The elderly who had committed suicide experienced more long-term life events. The top three most frequent life events were being diagnosed with chronic disease, hospitalization, and being diagnosed with terminal illness. Women more often experienced the death of spouse, while men experienced more hospitalization, and were more likely to be diagnosed with terminal illness and suffer family poverty. The risk of suicide among the elderly who experience life events was 12.8 times higher than that in people who did not experience life events. The elderly who were having unstable marital status, suffering from physical diseases and diagnosed with mental disorders, are more likely to commit suicide.Conclusions Understanding the pattern of life events which precede suicides among the elderly in rural China plays an important role in the prevention of suicide. Several different long-term life events can lead to suicidal behavior, and the effect of life events on suicide is cumulative. Being diagnosed with a serious disease may be one of the risk signals for suicide among the elderly.

Physical diseases and elderly suicide in rural China: A case–control psychological autopsy study

2021 ◽  
pp. 000486742199880
Author(s):  
Guojun Wang ◽  
Cunxian Jia ◽  
Zhenyu Ma ◽  
Liang Zhou
Keyword(s):  
Depressive Symptoms ◽  
Mental Disorders ◽  
Rural China ◽  
Severity Index ◽  
The Elderly ◽  
Case Control ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Physical Diseases ◽  
The Relationship

Objectives: Physical diseases are well-established risk factor for suicide, particularly among older adults. However, little is known about the underlying mechanism of the association. This study aimed to describe the prevalence of physical diseases and their influences on the elderly in rural China and to examine the underlying mechanisms of the relationship between physical diseases and suicide. Methods: This matched case–control psychological autopsy study was conducted from June 2014 to September 2015. Consecutive suicide cases (242) among people aged 60 years or above were identified in three Chinese provinces. The suicide cases were 1:1 matched with living comparisons based on age, gender and residential area. Two informants for each participant were interviewed to collect data on their demographic characteristics, the severity index of physical diseases, depressive symptoms, feelings of hopelessness, mental disorders and social support. Results: A significant difference was found between suicide cases and living comparisons regarding the prevalence of physical diseases (83.5% vs 66.5%, p < 0.001) and their severity (11.3 ± 6.2 vs 6.7 ± 5.3, p < 0.001). Independent risks of suicide included the following: not currently married (OR = 2.81, 95% CI = [1.04, 7.62]), mental disorders (OR = 7.18, 95% CI = [1.83, 28.13]), depressive symptoms (OR = 1.15, 95% CI = [1.05, 1.26]) and feelings of hopelessness (OR = 1.51, 95% CI = [1.20, 1.90]). The structural equation model indicated that the relationship between the severity index of physical diseases and suicide was mediated by depressive symptoms, feelings of hopelessness and mental disorders. Conclusion: The severity and number of physical diseases were found to be correlated with suicide among the elderly in rural China, after controlling for demographic characteristics. Physical diseases elevate one’s suicide risk by increasing depressive symptoms, feelings of hopelessness and mental disorders. Efforts for suicide prevention should be integrated with strategies to treat physical diseases along with psychological interventions.

scholarly journals Loneliness, hopelessness and suicide in later life: a case–control psychological autopsy study in rural China

2020 ◽  
Vol 29 ◽  
Author(s):  
Lu Niu ◽  
Cunxian Jia ◽  
Zhenyu Ma ◽  
Guojun Wang ◽  
Bin Sun ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Logistic Regression ◽  
Depressive Symptoms ◽  
Rural China ◽  
Case Control ◽  
Living Alone ◽  
Psychological Autopsy ◽  
Tree Model ◽  
Elderly Suicide

Abstract Aims Loneliness is increasingly recognised as a serious public health issue worldwide. However, there is scarce research addressing the association between loneliness and suicide in older adults in rural China. We set out to examine loneliness and other psychosocial factors in elderly suicide cases and explore their interaction effects. Methods Using a 1 : 1 matched case–control design, data were collected from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including demographic characteristics, loneliness, depression, hopelessness and social support. The chi-square automatic interaction detection (CHAID) tree model and multivariable logistic regression analysis were used to explore the relationships of these factors and suicide. Results The CHAID tree model showed that loneliness, hopelessness and depressive symptoms were closely associated with completed suicide and that loneliness and hopelessness interacted with each other. The result of multivariable logistic regression showed that individuals who were unemployed [odds ratio (OR) = 2.344; 95% confidence interval (CI): 1.233–4.457], living alone (OR = 2.176; 95% CI: 1.113–4.254), had lower levels of subjective social support (OR = 2.185; 95% CI: 1.243–3.843), experienced depressive symptoms (OR = 6.700; 95% CI: 3.405–13.182), showed higher levels of hopelessness (OR = 7.253; 95% CI: 3.764–13.974) and felt higher levels of hopelessness × higher levels of loneliness (OR = 2.446; 95% CI: 1.089–5.492) were significantly associated with an elevated suicide risk in older people in rural China. Conclusions Regular evaluation of loneliness, hopelessness and depression can help detect older adults who are at risk of committing suicide. Interventions should target social support systems, particularly among people living alone, to alleviate feelings of loneliness and hopelessness. Treating depression is also key to preventing suicide among elderly people in rural China.

scholarly journals Being left-behind, mental disorder, and elderly suicide in rural China: a case–control psychological autopsy study

2018 ◽  
Vol 49 (3) ◽  
pp. 458-464 ◽  
Author(s):  
Liang Zhou ◽  
Guojun Wang ◽  
Cunxian Jia ◽  
Zhenyu Ma
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Mental Disorder ◽  
Life Events ◽  
Stressful Life Events ◽  
Case Control ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Left Behind ◽  
Elderly Suicide

AbstractBackgroundSuicide rate among rural elderly is the highest among all age groups in China, yet little is known about the suicide risks in this rapidly growing vulnerable population.MethodsThis matched case–control psychological autopsy study was conducted during June 2014 to September 2015. Consecutive samples of suicides aged 60 or above were identified in three provinces (Shandong, Hunan, and Guangxi) in China. Living comparisons were 1:1 matched with the suicides in age (±3 years old), gender, and living location. Risk factors included demographic characteristics, being left-behind, mental disorder, depressive symptoms, stressful life events, and social support.ResultsA total of 242 suicides and 242 comparisons were enrolled: 135 (55.8%) were male, mean (s.d.) age was 74 (8) years. The most frequently used suicide means were pesticides (125, 51.7%) and hanging (95, 39.3%). Independent risks of suicide included unstable marital status [odds ratio (OR) 4.19, 95% confidence interval (CI) 1.61–10.92], unemployed (compared with employed, OR 4.43, 95% CI 1.09–17.95), depressive symptoms (OR 1.34, 95% CI 1.21–1.48), and mental disorder (OR 6.28, 95% CI 1.75–22.54). Structural equation model indicated that the association between being left-behind and suicide was mediated by mental disorder, depressive symptoms, stressful life events, and social support.ConclusionsUnstable marital status, unemployed, depressive symptoms, and mental disorder are independent risk factors for suicide in rural elderly. Being left-behind can elevate the suicide risk through increasing life stresses, depressive symptoms, mental disorder, and decreasing social support. Elderly suicide may be prevented by restricting pesticides, training rural physicians, treating mental disorders, mitigating life stress, and enhancing social connection.

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